liver is the largest organ of the body situated on the right side of the abdomen under your rib cage. It performs more than 5,000 separate bodily functions from cleaning the blood from harmful substances to converting food into nutrients to controlling body’s hormone levels. Most people never give their liver a thought until something goes wrong. In fact, there are many types of liver diseases that can be caused by a virus, drugs or chemicals, obesity, diabetes or an attack from your immune system.
Many common liver diseases can cause the organ to become inflamed. This inflammation can progress to scarring or cirrhosis. It is critical that patients with cirrhosis, due to any type of liver disease, seek help because people with cirrhosis are at increased risk of liver cancer and liver failure.
Here are some common liver problems.
Fatty liver: It is a condition in which excess fat in the liver more than 5-10 per cent of the body weight. This condition is most common in those who are overweight, diabetic or have metabolic syndrome. If this fatty liver is not related to alcohol then it is called non- alcoholic fatty liver disease. Steatosis is a mild form of fatty liver. In some patients with steatosis, inflammation of the liver may occur with resultant hepatitis called non-alcoholic steatohepatitis (NASH). Treatment includes weight loss, exercise, diabetes control, regulating blood pressure and cholesterol, eliminating alcohol consumption.
Cirrhosis of liver: Cirrhosis is a term that refers to a consequence of chronic liver diseases in which normal liver cells are damaged and replaced by scar tissue, decreasing the amount of normal liver tissue.The distortion of the normal liver structure by the scar tissue interferes with the flow of blood through the liver. It also handicaps the function of the liver, which, with the loss of normal liver tissue, leads to failure of the liver to perform some of its critically important functions. Treatment depends on the type and stage of the cirrhosis. It aims to stop the progress of the cirrhosis, reverse (to whatever extent possible) the damage that has already occurred, and treat complications that are disabling or life-threatening.
Viral hepatitis: Viral hepatitis is a very common caused by a group of viruses hepatitis A, B, C, E. Hepatitis A infection is usually caused by consuming contaminated food or water.
This form of hepatitis usually clears without lasting problems within six months and does not lead to a chronic infection. Typically you cannot get more than once since it causes lifetime immunity after first infection. Hepatitis A vaccine is available to preventv the infection.Hepatitis B is a serious disease caused by a virus that attacks the liver (Hepatitis B virus - HBV). Infection with the HBV may be without any symptoms, mild or severe. Over time, hepatitis B can destroy the liver (cirrhosis) and can cause hepatocellular carcinoma (liver cancer).
It has been estimated there are approximately 350 million HBV carriers in the world, of which 80 per cent are Asians. HBV is reported to be 100 times more infectious than HIV. It is normally successfully treated with oral medications that have few side effects or pegylated interferon injections. Hepatitis B vaccine is available to prevent the infection.
Hepatitis C spreads through contact with infected blood. Hepatitis C infection can be very serious. Most people infected with the hepatitis C virus (HCV) have no symptoms.In fact, most people don’t know they have the hepatitis C infection until liver damage shows up, decades later, during routine medical tests. Treatment includes antiviral medicines, such as pegylated interferon and ribavirin to limit liver damage.
No vaccine is available to prevent hepatitis C. Hepatitis E is usually self-limiting but may develop into fulminant hepatitis (acute liver failure). The hepatitis E virus is transmitted via contaminated water. It is found worldwide, but the prevalence is highest in East and South Asia.There is no available treatment capable of altering the course of acute hepatitis. Prevention is the most effective approach against the disease. As hepatitis E is usually self-limiting, hospitalization is generally not required. However, hospitalization is required for people with fulminant hepatitis and should also be considered for infected pregnant women. Alcoholic liver disease: Alcoholic hepatitis describes liver inflammation caused by drinking alcohol.
Though alcoholic hepatitis is most likely to occur in people who drink heavily over many years, the relationship between drinking and alcoholic hepatitis is complex. Not all heavy drinkers develop alcoholic hepatitis, and the disease can occur in people who drink only moderately. If you’re diagnosed with alcoholic hepatitis, you must stop drinking alcohol. People who continue to drink alcohol face a high risk of serious liver damage and death.
Autoimmune hepatitis: Autoimmune hepatitis is inflammation in your liver that occurs when your body’s immune system attacks your liver.Although the cause of autoimmune hepatitis isn’t entirely clear, some diseases, toxins and drugs may trigger autoimmune hepatitis in susceptible people, especially women. Untreated autoimmune hepatitis can lead to scarring of the liver (cirrhosis) and eventually to liver failure. When diagnosed and treated early, however, autoimmune hepatitis often can be controlled with drugs that suppress the immune system.
Genetic liver disease: There are many inherited diseases that affect the liver but only three genetically determined diseases in which the liver may be the principal target organ, with manifestations of acute, sub acute, or chronic disease that may become evident in early or later life.
These are hereditary hemochromatosis (HH), a major disorder of iron overload, Wilson’s disease, a genetic disorder of copper overload, and alpha1-antitrypsin (a1-AT) deficiency, a disorder in which the normal processing of a liver-produced protein is disturbed within the liver cell. Awareness of the clinical features of inherited metabolic liver diseases should promote proactive diagnostic evaluation.
The clinical features of certain inherited metabolic liver diseases may manifest in childhood, disappear during growth and development, and reappear in adult life. Molecular diagnostic testing has made genotypic evaluation available for some diseases to complement clinical diagnosis. Preemptive treatment may prevent the development of clinical complications in some diseases (e.g., hereditary hemochromatosis and Wilson’s disease), and liver transplantation may be curative in others (e.g., alpha1-antitrypsin deficiency and Wilson’s disease).
Awareness about liver transplant: A liver transplant is a surgical procedure to remove a diseased liver and replace it with a healthy liver from a donor. Most liver transplant operations use livers from deceased donors, though a liver may also come from a living donor. liver transplant is a treatment option for people who have end-stage liver failure that can’t be controlled using other treatments and for some people with liver cancer. A small percentage of liver transplants are completed each year using a portion of a liver from a living donor.
If you have a family member or friend who is willing to donate part of his or her liver to you, talk to your transplant team about this option. living-donor transplants have good results, just like transplants using livers from deceased donors.
But fewer living transplants are performed because of restrictions on the donor’s age, size and health that make finding a good match difficult. The surgery carries significant risks for the donor. Your transplant team can discuss the risks with you and the potential donor.
Expect six months to a year of recovery before you’ll feel fully healed after your liver transplant surgery. How long it takes you to recover may depend on how ill you were before your liver transplant. Your chances of a successful liver transplant and long-term survival depend on your particular situation.In general, about 72 per cent of people who undergo liver transplant live for at least five years. As a stitch in time saves nine, it is always better to take care of your liver before it goes wrong.
(The writers are from the Apollo Hospitals, Bhubaneswar)